Provider Demographics
NPI:1760690119
Name:DAVIES, ROBIN DIANA (DMD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:DIANA
Last Name:DAVIES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KENT WAY
Mailing Address - Street 2:
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922-1220
Mailing Address - Country:US
Mailing Address - Phone:978-255-1891
Mailing Address - Fax:978-255-1863
Practice Address - Street 1:3 KENT WAY
Practice Address - Street 2:
Practice Address - City:BYFIELD
Practice Address - State:MA
Practice Address - Zip Code:01922-1220
Practice Address - Country:US
Practice Address - Phone:978-255-1891
Practice Address - Fax:978-255-1863
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19468122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist